Provider Demographics
NPI:1346792454
Name:ROCKY MOUNTAIN HOLDINGS, LLC
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN HOLDINGS, LLC
Other - Org Name:VANDERBILT LIFEFLIGHT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:BROCK
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-636-4438
Mailing Address - Street 1:PO BOX 713362
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45271-3362
Mailing Address - Country:US
Mailing Address - Phone:888-636-4438
Mailing Address - Fax:
Practice Address - Street 1:807 WILLIAM NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:TULLAHOMA
Practice Address - State:TN
Practice Address - Zip Code:37388-4734
Practice Address - Country:US
Practice Address - Phone:931-461-9093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AIR METHODS CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-25
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNEMS00000101893416A0800X
3416A0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4562156Medicaid
TN103G591470Medicare UPIN